Abnormal Cardiac Function After Exercise in Insulin-Dependent Diabetic Children and Adolescents

Victor C Baum, MD,

Lynne L Levitsky, MD and

Robert M Englander, AB

Divisions of Cardiology and Endocrinology and Metabolism, Department of Pediatrics, and the Department of Anesthesiology, Michael Reese Hospital and Medical Center; and the Pritzker School of Medicine, The University of Chicago Chicago, Illinois

Abstract

We evaluated the cardiac response to dynamic exercise in a group of otherwise healthy insulin-dependent older children and adolescents and in a nondiabetic control group by postexercise echocardiography. Both groups had similar left ventricular function at rest. After exercise we found abnormalities in the indicators of systolic function, fractional shortening (0.37 vs. 0.43) and rate-corrected velocity of circumferential fiber shortening (2.80 vs.3.35 circumferences/s). In addition, we found an association of flattened interventricular septal motion with finger contractures in the diabetic subjects. Echocardiographic abnormalities in asymptomatic young diabetic adolescents can be elucidated by postexercise echocardiography. Postexercise echocardiography is a noninvasive procedure that can easily be done in the adolescent population and is useful for evaluating subclinical cardiomyopathy.